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Updated: May 12, 2026
Murine Hind Limb Long Bone Dissection and Bone Marrow Isolation
Published on: April 14, 2016
Incidence of skeletal-related events over time from solid tumour bone metastases reported in randomised trials using
1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Aims:
Skeletal-related events (SREs) in patients with bone metastases decrease a patient's quality of life and functional status. Although bone-modifying agents have been found to reduce the time to first on-trial SRE and decrease the total incidence of SREs in randomised clinical trials, standard practice in the management of bone metastases has changed concurrently. The purpose of this study was to investigate if advances in bone-targeted therapies have decreased the incidence of individual types of SREs and to delineate the trend of SREs.
Materials And Methods:
A literature review was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to identify phase III, randomised bisphosphonate and other bone-targeted therapy trials from 1980 to September 2011. For all studies, a mean year of enrolment ([start of enrolment + end of enrolment]/2) was calculated. The incidences of SREs were tabulated and expressed as percentages of on-trial patients. Generalised linear mixed models were used to search for the trends of SREs over time for all placebo and intervention arms. Regression coefficients were interpreted as the odds ratio, which was calculated using the exponential of the slope. Ninety-five per cent confidence intervals were also calculated.
Results:
In total, 20 eligible studies were identified that reported SRE data from phase III trials, of which 11 were suitable for the quantitative analysis. Most of the articles included patients with breast cancer and the remaining involved patients with prostate, renal cell, bladder and lung cancer or other solid tumours. Enrolment periods for all included data ranged from 1990 to 2009. Statistically significant overall downward trends in pathological fractures and the need for surgery were seen over time. Also significant differences between intervention and placebo were seen with all SREs.
Conclusion:
The decrease in SREs over time may not only be a result of the development of new generation bone-targeted agents, but also due to better systemic management and awareness of events associated with bone metastases.
Insights
Advances in bone-targeted therapies and improved patient management have decreased skeletal-related events (SREs) over time. This study analyzed trends in SREs, finding significant reductions in pathological fractures and surgery needs in patients with bone metastases.
Area of Science:
- Oncology
- Bone Metastasis Research
- Clinical Trial Analysis
Background:
- Skeletal-related events (SREs) significantly impair quality of life and function in patients with bone metastases.
- Bone-modifying agents have shown efficacy in reducing SREs in clinical trials.
- Evolving management practices for bone metastases necessitate an updated understanding of SRE trends.
Purpose of the Study:
- To investigate the impact of advancements in bone-targeted therapies on individual SRE incidence.
- To delineate temporal trends in the occurrence of SREs in patients with bone metastases.
- To assess changes in SREs beyond overall incidence.
Main Methods:
- Conducted a literature review of phase III randomized trials of bisphosphonates and bone-targeted therapies (1980-2011).
- Utilized data from 20 eligible studies, with 11 suitable for quantitative analysis.
- Employed generalized linear mixed models to analyze SRE trends over time, calculating odds ratios and confidence intervals.
Main Results:
- Identified significant downward trends in pathological fractures and the need for surgery over time.
- Observed statistically significant differences in SREs between intervention and placebo groups across all SRE types.
- Data primarily included patients with breast cancer, but also encompassed prostate, renal cell, bladder, lung, and other solid tumors.
Conclusions:
- The observed decrease in SREs may be attributed to both novel bone-targeted agents and improved systemic care.
- Enhanced awareness and management of bone metastasis complications contribute to reduced SRE incidence.
- These findings highlight the multifaceted progress in managing bone metastases and their associated skeletal events.
